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Chronic pain still widely untreated and misunderstood

ELEANOR HALL: Chronic pain is a condition which affects one in five Australians and costs the country $39 billion a year in health care alone

But experts say itís the most neglected and misunderstood health condition in the developed world

Deborah Cornwall prepared this report.

MIKE WINTLER: The pain was intense. I had been living on Panadeine Forte and Oxycontin for years. Going from specialist to specialist, I was emotionally burnt out, I was physically burnt out and really just a burden on society to be honest with you. I was a mess, life was a bloody mess.

DEBORAH CORNWALL: Mike Winkler was in his early 40s when he had a neck injury 15 years ago, and has been on the medical circuit ever since.

But after years of excruciating pain, and seven back operations, it's only recently he was referred to Australia's leading pain medicine specialist, professor Michael Cousins. The relief was instant.

MIKE WINTLER: The feeling is of elation just about. I mean it gives me an opportunity to get on with my life. I can walk, I can bend over, I can move my feet; I have feeling. It is great.

DEBORAH CORNWALL: Mike Winkler was fitted with an electrical stimulator to his spine, but just as critically professor Cousins' team of specialists at the Northern Private Pain Centre on Sydney's north shore, also went to work on the psychological and social damage caused by years of crippling pain.

MIKE WINTLER: People just think you are bunging it on they don't have any concept of what it's doing to your life..DEBORAH CORNWALL: Professor Cousins says chronic pain is so badly misunderstood and mistreated by health professionals; Mike Winkler's experience is typical of most sufferers.

MICHAEL COUSINS: It is a miserable condition to have. And indeed we found that people who report severe chronic pain often have a level of disability that is greater than those with congestive cardiac failure. Now that really puts it in perspective, this is a very, very severe disease.

DEBORAH CORNWALL: While there are some 500 medical conditions defined as chronic pain disease, professor Cousins says lower back pain is by far the most common. Yet it's those patients who are most likely to be dismissed as hypochondriacs and malingerers.

Professor Cousins says the tragedy for most chronic pain sufferers is their disease may have been avoided altogether had they been properly treated in the first six months.

Chronic pain, he says, is generally caused by an acute injury initially, such as back sprain or so called slipped disc, but the brain continues to register the pain long after the injury has healed.

MICHAEL COUSINS: At the moment very few GPs have the resources of a clinical psychologist and a physio who are actually trained in spotting patients who are in the transition phase from acute pain to chronic pain. If you don't do anything to intervene those changes are going to get worse and they will be associated with a perpetuation of the pain.

DEBORAH CORNWALL: Backed by National Information and Communications Technology Australia professor Cousins is currently working with the medical device research company Saluda, trialling a world first spinal stimulation device that provides pain relief by tracking a patientís nerve cell function.

Mike Winkler can't wait for it to be approved.

MIKE WINKLER: The device I have at the moment is pretty much set at a level which gives me comfort. The new device, brilliant. I trialled that for a few hours and the resultís just been phenomenal.

DEBORAH CORNWALL: Professor Cousins says while it's still several years away from approval, the hope is the new device will prove a major breakthrough. Especially for the 20 per cent of chronic pain sufferers who get little or no relief at all from current treatments.